Yoga for Heart Palpitations During Perimenopause: A Calm Approach

That unsettling flutter in your chest

You are sitting quietly, trying to sleep, or doing something completely ordinary when you feel your heart skip, flutter, or beat harder than it should. It lasts a few seconds and then passes. But it is alarming, and it keeps happening.

Heart palpitations are reported by a significant proportion of women during perimenopause, and they are one of the symptoms that tends to cause the most anxiety. The fear that something is seriously wrong with your heart is understandable, but for many women these palpitations are directly related to hormonal fluctuation rather than a cardiac problem. Once serious causes are ruled out by a doctor, understanding what drives them and what can help becomes the focus.

Why heart palpitations happen during perimenopause

Estrogen has a direct effect on the cardiovascular system. It helps regulate heart rate through its influence on the autonomic nervous system, the system that controls automatic body functions including heart rhythm. As estrogen levels fluctuate during perimenopause, the electrical signaling that keeps heart rhythm steady can become more variable.

The autonomic nervous system becomes more reactive during perimenopause. The sympathetic branch, responsible for fight-or-flight responses, can become more hair-trigger. Palpitations often occur when the sympathetic system fires more strongly than the situation warrants, producing a racing, skipping, or thumping sensation in the chest.

Caffeine, alcohol, dehydration, hot flashes, and high stress all lower the threshold at which palpitations occur during this transition. Managing these triggers is a practical first step alongside any movement practice.

How yoga may help reduce palpitations

Yoga addresses perimenopause-related palpitations primarily through its effects on the autonomic nervous system. The slow, controlled breathing that is central to yoga practice directly activates the parasympathetic nervous system, the calming counterpart to fight-or-flight. Extended exhale breathing, where the out-breath is longer than the in-breath, is particularly effective at reducing sympathetic nervous system activity and slowing heart rate.

Regular yoga practice over weeks and months tends to produce a measurable shift in autonomic balance, with practitioners showing lower resting heart rates and reduced reactivity to stress. This more calibrated nervous system is less likely to produce the sharp sympathetic spikes that trigger palpitations.

Yoga also reduces overall cortisol and anxiety, both of which lower the threshold for sympathetic activation. The combination of acute breath-based regulation and longer-term nervous system rebalancing makes yoga a genuinely relevant tool for this symptom.

Specific yoga practices that may help

Breathwork is the most direct tool available within yoga for managing palpitations. Extended exhale breathing, breathing in for four counts and out for six to eight counts, should be practiced for five to ten minutes daily as a standalone practice, not only during yoga sessions. This builds the parasympathetic reflex that counters the palpitation trigger.

Alternate nostril breathing (nadi shodhana) is another highly effective technique. Breathing through one nostril at a time using a specific hand position has been shown in research to reduce sympathetic nervous system activity and support heart rate variability.

For physical poses, choose calming and grounded options. Legs-up-the-wall (viparita karani), supported reclined butterfly pose, and seated forward folds all activate the parasympathetic system while remaining safe and accessible. Avoid inverted poses where your head goes significantly below your heart if palpitations are frequent, at least until you have been cleared by your healthcare provider.

Practice in a cool, well-ventilated room. Heat can trigger palpitations, so hot yoga is not appropriate during a period of frequent symptoms.

What the research says

Research on yoga for cardiac symptoms and autonomic nervous system function has found consistent improvements in heart rate variability, a measure of how well the heart responds to and recovers from stress. Higher heart rate variability is associated with better cardiovascular health and fewer palpitation episodes.

Studies in menopausal and perimenopausal women specifically have found that regular yoga practice reduces the self-reported frequency of palpitations and the distress associated with them. Breathwork-based interventions, including those used in yoga, have a particularly strong evidence base for reducing sympathetic nervous system reactivity and supporting cardiac rhythm regulation.

Tips for getting started safely

Before beginning or intensifying any exercise practice if you are experiencing palpitations, it is worth getting a basic cardiac evaluation from your healthcare provider. Most perimenopausal palpitations are benign, but ruling out arrhythmias or structural heart issues first gives you a confident foundation to work from.

Once cleared, start with gentle, floor-based yoga and breathwork rather than active standing or flowing sequences. The calming practices tend to be most directly useful for palpitations, and they are also the lowest-risk starting point.

Build in a five-minute breathwork practice morning and evening regardless of whether you do a full yoga session. Consistency with breathwork tends to produce faster autonomic changes than irregular practice.

How tracking your progress helps

Palpitations can be difficult to track reliably if they are brief and occur at unpredictable times. Keeping a log of when they occur, what you were doing, and any potential triggers, alongside your yoga and breathwork practice, helps you identify your personal patterns over time.

PeriPlan lets you log your workouts and symptoms together, so you can see whether your yoga and breathwork days correspond with fewer palpitation episodes. Identifying triggers like caffeine, alcohol, heat, or stress as reliably preceding your symptoms is genuinely useful information to have and to discuss with a healthcare provider.

If palpitations are accompanied by chest pain, shortness of breath, dizziness, or fainting, seek medical attention promptly. These symptoms warrant evaluation regardless of a prior benign diagnosis.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.